<%@ page language="java" import="java.util.*" pageEncoding="utf-8"%>
<%@ include file="/WEB-INF/jsp/component/common.jsp" %>
    
        <div class="modal-dialog" >
            <div class="modal-content">
            
                <div class="modal-header">
                    <button type="button" class="close" data-dismiss="modal" aria-hidden="true"> &times; </button>
                    <h4 class="modal-title">糖尿病检测</h4>
                </div>
                
                <div class="modal-body">
                <form class="form-horizontal" role="form" id="showForm" name="" action="" method="">
					<div class="form-body">
					<div class="form-group">
						<label class="col-md-4 control-label">糖化白蛋白(mmol/L)：</label>
						<div class="col-md-2">
							<input type="text" class="form-control  input-middel" name="" value="${resultData.resultMap.item_109001 }" />
						</div>
						<label class="col-md-2 control-label">结论：</label>
						<div class="col-md-4">
							<input type="text" class="form-control  input-middel" name="" value="${resultData.resultMap.item_109001_report }"  />
						</div>
					</div>

		            <div class="form-group">
						<label class="col-md-4 control-label">葡萄糖(umol/L)：</label>
						<div class="col-md-2">
							<input type="text" class="form-control  input-middel" name="" value="${resultData.resultMap.item_109002 }" />
						</div>
						<label class="col-md-2 control-label">结论：</label>
						<div class="col-md-4">
							<input type="text" class="form-control  input-middel" name="" value="${resultData.resultMap.item_109002_report }"  />
						</div>
					</div>
					
					<div class="form-group">
						<label class="col-md-4 control-label">白蛋白(mmol/L)：</label>
						<div class="col-md-2">
							<input type="text" class="form-control  input-middel" name="" value="${resultData.resultMap.item_109003 }"  />
						</div>
						<label class="col-md-2 control-label">结论：</label>
						<div class="col-md-4">
							<input type="text" class="form-control  input-middel" name="" value="${resultData.resultMap.item_109003_report }"  />
						</div>
					</div>
					
					<div class="form-group">
						<label class="col-md-4 control-label">糖化血红蛋白(mmol/L)：</label>
						<div class="col-md-2">
							<input type="text" class="form-control  input-middel" name="" value="${resultData.resultMap.item_109004 }"  />
						</div>
						<label class="col-md-2 control-label">结论：</label>
						<div class="col-md-4">
							<input type="text" class="form-control  input-middel" name="" value="${resultData.resultMap.item_109004_report }"  />
						</div>
					</div>
					
					<div class="form-group">
						<label class="col-md-4 control-label">糖化白蛋白值(%)：</label>
						<div class="col-md-2">
							<input type="text" class="form-control  input-middel" name="" value="${resultData.resultMap.item_109005 }"  />
						</div>
						<label class="col-md-2 control-label">结论：</label>
						<div class="col-md-4">
							<input type="text" class="form-control  input-middel" name="" value="${resultData.resultMap.item_109005_report }"  />
						</div>
					</div>
					
					
					</div>
					
				</form>
                </div>
                
                <div class="modal-footer">
                    <button type="button" class="btn btn-default" data-dismiss="modal">关闭</button>
                </div>
                
            </div>
        </div>
    
<script type="text/javascript">

</script>